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© 2015 Dr. Cynthia Bailey Skin Care, LLC Rosacea Understanding what it is and w

© 2015 Dr. Cynthia Bailey Skin Care, LLC Rosacea Understanding what it is and what you can do about it © 2015 Dr. Cynthia Bailey Skin Care, LLC Table of Contents Introduction What is rosacea? Why do people get rosacea? Designing a skin care program Lifestyle and activities References Bio What are the different forms of rosacea? Identifying rosacea Beyond skin care Final considerations 2 3 4 7 8 10 18 20 21 22 © 2015 Dr. Cynthia Bailey Skin Care, LLC If you suffer from rosacea, you’re in good company since it is very common. According to the National Rosacea Society, “well over 16 million Americans have rosacea - and most don’t know it.” This common aspect of rosacea does not, however, mean that rosacea is well understood, or that there are sure fire ways to control it. If you’re reading this, then you may already have experienced how tricky and sensitive rosacea-prone skin is. My goal is to share with you what I’ve learned in my 25 years of dermatology practice caring for thousands of different complexions that suffer from rosacea. I also have rosacea myself, giving me a first-hand opportunity to experience it and apply my dermatologic experience and medical knowledge against thousands of skin care products and their claims. In this guide, my hope is to help you better understand rosacea and teach you how to identify some of the more subtle signs. I’ll give you my guidelines for choosing the right skin care products and treatments for your complexion and help you understand when you need to see a dermatologist for prescription treatments. Introduction Are you one of the 16 million Americans suffering from rosacea? Dr. Bailey is here to help. © 2015 Dr. Cynthia Bailey Skin Care, LLC What is rosacea? Rosacea may at times looks like a form of acne, but it’s really a skin rash that starts in adulthood. This is an important distinction because the treatments that work for acne often don’t work for rosacea. Any adult is at risk, but rosacea is most commonly seen in light skinned women between the ages of 30 to 50. Rosacea is characterized by persistent redness of the rounded areas of the face, including the cheeks, nose, chin and mid-forehead. It often spares the skin around the eyes. Although the skin looks red, hot and inflamed, it is not infected. Rosacea is an inflammatory condition. The location and pattern of the inflammation determine the type or types of rosacea a person has. There are 4 different subtypes of rosacea. It’s important for you to try to identify which type you have because it helps you understand your skin problem and find the best skin care routine for treatment and control. You may also find that you have more than one rosacea type, which is very common. 4 types of rosacea 4 types of rosacea © 2015 Dr. Cynthia Bailey Skin Care, LLC What are the different forms of rosacea? Erythematotelangiectatic rosacea Papulopustular rosacea Erythematotelangiectatic rosacea is the subtype of rosacea where inflammation is more diffused into the skin and is associated with redness and flushing. The inflammation may be dramatic, or it may be quite subtle. There is often a history of flushing episodes lasting over 10 minutes and occurring from various stimuli including emotional stress, hot drinks, alcohol, spicy foods, exercise, cold or hot weather, hot baths or showers, etc. The skin may sting or burn with flushing. The skin is often finely textured with scaling and roughness of the central face, which is a big indication that the facial skin may also be very sensitive. Also, this means that skin care products and harsh climates have been unusually irritating in the past causing facial redness, scaling and discomfort. Papulopustular rosacea is the classic rosacea subtype. Skin inflammation is heavily centered around the pore, causing pimple-like redness and swelling, sometimes with pustules and nodules. There is often a history of flushing. There may or may not be a history of sensitive skin.The skin may be sebaceous and oily, red, thick and swollen. © 2015 Dr. Cynthia Bailey Skin Care, LLC What are the different forms of rosacea? Glandular rosacea with or without rhynophyma is a deep sebaceous rosacea subtype, most commonly seen in men with a history of teenage acne. Flushing and telangiectasias (“broken capillaries”) are less prominent. Skin is thick and sebaceous and is not sensitive or easily irritated. Pores are large and filled with plugs of dead skin cells and sebum.There is swelling and enlargement of the oil glands that is classically evidenced by a larger rounded nose. Ocular rosacea is inflammation of the oil glands along the eyelash line. It can be seen with all the types of rosacea.Some studies have linked it to demodex mites. There can be redness, irritation and grittiness of the eyes, stinging, burning and light sensitivity. Ocular rosacea may precede facial skin involvement. Ocular Rosacea Glandular Rosacea © 2015 Dr. Cynthia Bailey Skin Care, LLC Facial Distribution of seborrheic dermatitis: Note the involvement along the nose, between the brows and on the mid forehead, areas that are not involved with rosacea. Seborrhea causes a pinkish-salmon rash that is dry and flaky as well as sensitive skin, a.k.a. dandruff. Sebaceous hyperplasia papules (small waxy yellow bumps with a central pore) are seen in all types of rosacea. They are actually solid growths/ enlargements of an oil gland. They can be surgically treated with electro-cautery or laser. They are often misidentified as milia, which are small pinpoint skin cysts that can be lanced by a doctor. Unfortunately, sebaceous hyperplasia papules are solid and will not go away when lanced. Rosacea occurs in all skin colors/ ethnicities but is most common in fair-skinned people. Rosacea can involve non-facial skin such as the neck and chest. Many people with rosacea, espe- cially the erythematotelangiectatic type of rosacea, also have facial seborrheic dermatitis, also known as dandruff. What are the different forms of rosacea? What you need to know about all types of rosacea Rosacea Seborrheic Dermatitis © 2015 Dr. Cynthia Bailey Skin Care, LLC Why do people get rosacea? We don’t know! What we do know: The regulation of blood flow to the skin in rosacea is abnormal. People with rosacea have an abnormal “vasomotor” response of their facial capillaries to hot environments and other flushing stimuli, leading to easy and frequent flushing. Demodex mites have been implicated in some studies. However, the role of demodex mites remains controversial. A re- cent study suggests that protein on bacteria on the mites might be important, but it’s a to-be-continued-story because: Pores with demodex are more likely to be inflamed, but 100% of the elderly have demodex in their pores though not all have rosacea. The presence of demodex is most closely associated with inflammatory papulopustular rosacea. Killing the demodex with medicine does not necessarily cure rosacea. Intestinal bacteria such as h. pylori have been implicated as well, but there is evidence both for and against this hypothesis. It may turn out that it’s more important for some people than others. Demodex Mites Intestinal Bacteria Abnormal Blood flow regulation © 2015 Dr. Cynthia Bailey Skin Care, LLC Tips to tell acne from rosacea Top Three conditions that mimic rosacea 1. 1. 2. 2. 3. 3. How do you identify whether or not your complexion problems are due to rosacea? Skin rashes of allergic and irritant dermatitis Facial dandruff (seborrheic dermatitis) Non-rosacea forms of acne Female hormonal acne, another form of acne that can develop in adult women, usually manifests as big, painful cysts along the jaw. This is not a common site for the pimple-like lesions or rash of rosacea. Look for blackheads - not just engorged and clogged pores. Blackheads are more common in acne. How old are you? Acne is more common in adolescents and young adults. Rosacea is more common in young and older adults, and the risk of rosacea increases with age. © 2015 Dr. Cynthia Bailey Skin Care, LLC An allergy or irritation from products is located only where the product is being applied in the beginning of the rash. The rash may eventually spread out from that area, but in the beginning, it starts where the product was applied. There is often an itching with allergic reactions. Poison oak or ivy is a classic example of allergic dermatitis and many ingredients in skin care products can be allergens too. There is often a dry, chapped appearance to the skin associated with stinging when a product is causing an irritant reaction. Classic examples are AHA or acne products (especially benzoyl peroxide products) that are too strong for a person’s skin. Dandruff can be harder to distinguish from rosacea. It often involves the mid-portion of the face just like rosacea. With dandruff, there is scaling and a salmon-colored redness of the skin. Involved areas are often sensitive as well. Dandruff usually involves the eyebrows, hairline, ears, and along the sides of the nose more than the convex uploads/Geographie/ rosacea-guide.pdf